Measuring zinc Status
Eighty-five percent of absorbed zinc is bound to albumin and travels via the portal circulation to the liver for distribution to the tissues. A broad range of normal exists for serum zinc (95-130 mcg/dl)14 and hemolysis, fasting and variations in albumin concentration will create variations in measured serum zinc. Assays of zinc in granulocytes and lymphocytes are more sensitive in diagnosing marginal zinc deficiency, but these tests are not widely used.1 20% of the zinc pool also exists within the skin, and even if tissue biopsy was practical, tissue concentration varies as well.
Measurements of alkaline phosphatase levels have been used to follow zinc status in those on parenteral nutrition, but no sensitive and practical test exists for detecting zinc deficiency. This has made the selection of participants and outcomes measured for research studies on zinc and wound healing difficult to define.
Wound healing
Collagen content and wound strength correlate with an adequate supply of wound healing nutrients including zinc during all phases of the wound healing process. However, the zinc concentration within naturally healing wounds changes according to the phase of the healing process and indicates optimal levels may be time dependent.2 For example, too much zinc in early days after a wound is believed to upset calcium concentrations necessary to the hemostatic phase,16 whereas zinc concentration in wounds increases during the formation of granulation tissue, scar tissue and during re-epithelialization. Further, different types of wounds may have different requirements for zinc, i.e., midline incisions rely heavily on fibroblast collagen deposition whereas skin graft donor sites rely more on epithelialization.
Zinc also impacts how other wound healing nutrients are utilized. For example, zinc containing proteins are needed for release of Vitamin A from the liver and for the tissue metabolism of vitamin A.19-21 Conversely, zinc and copper appear to use the same absorptive channel, and too much zinc can cause copper deficiency. A copper deficiency can interfere with the interaction between copper and lysyl oxidase, an enzyme involved in the cross-linking of collagen to increase wound strength.
Tags: an enzyme, collagen, Conversely, copper appear, copper deficiency, different types, fibroblast, further, granulation tissue, lysyl oxidase, Measuring, Measuring zinc status, Practical, scar tissue, status, tissue concentration, vitamin A.19-21, zinc
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